Power Outage Plan for a Parent on Oxygen or Medical Equipment

A power outage plan for a parent on oxygen or other powered medical equipment comes down to four things: a list of every device that plugs in, how many hours each one really runs without the wall, a backup for the ones that can't stop (oxygen tanks, spare batteries, a place with power), and a clear point at which someone leaves the house or calls 911. Write it on one page, tape a short card to each device, and test the batteries before you need them.

This guide is about the equipment itself. For utility medical registration, phone service and heat and cold during an outage, see our emergency plan for a parent living alone.

Start with what plugs in

Walk through the house with your parent and write down everything they rely on that uses electricity or a charger. Most families find something they hadn't thought of, usually the lift chair or the bed.

The resuscitation bag, manual wheelchair and backup oxygen come from PG&E's tips for people who use electric or battery dependent medical devices. The lift chair and hospital bed deserve their own question: "Is there a manual release, and where is it?" Better to learn that on a sunny afternoon than at 9 p.m. with your mother stuck halfway reclined.

How long does each battery actually last?

The number on the box is a best case. Real runtime depends on your parent's setting, the battery's age and the room temperature, so you want the number for your parent's machine at your parent's settings.

The FDA's free fill-in booklet, Home Use Devices: How to Prepare for and Handle Power Outages for Medical Devices that Require Electricity, makes a good script. It suggests one booklet per device, with answers gathered from the manufacturer or medical provider to questions like these:

• Does it have a backup system, how long will it operate, and where is it?
• Could your parent be harmed if it stops for a short time, and how short?
• What batteries does it use, and how long will it last on them?
• How do you switch it from battery to wall power?

Start with the user manual, then call the supplier for the rest. Then, with the supplier's okay, test it. On an ordinary day, run the device on battery at the usual setting and note when it started and when the low battery warning came on. Write that down in hours and retest yearly. Batteries lose capacity as they age, and nobody sends a letter when that happens.

Oxygen: tanks, the supplier and the outage policy

A concentrator pulls oxygen from room air and needs electricity to do it. Tanks need no power, but they empty. So for most people on home oxygen, the outage plan is really a tank plan.

Call the oxygen supplier and ask:

1. How many backup tanks can my parent keep, and how long does each last at their prescribed flow rate?
2. What's your policy when a storm or shutoff is forecast? Do you deliver extra tanks, and how far ahead do we ask?
3. What's the after-hours number, and does a person answer it?
4. Can you show us how to switch from the concentrator to a tank and read the gauge?

PG&E suggests asking the provider whether a reduced flow rate could stretch the supply. Get that answer in advance; don't turn the flow down on your own mid-outage.

Store tanks the way the supplier says, usually upright and secured so they can't tip, and show whoever has a key where they are.

Fire safety when the lights are out

The FDA's tips about medical devices and natural disasters say to use battery-powered flashlights or lanterns, not gas lights or torches, when oxygen is in use. The Red Cross gives everyone the same advice: use flashlights, not candles. Keep one with spare batteries by your parent's chair and bed.

The U.S. Fire Administration's oxygen tank safety guidance says to keep oxygen tanks at least 5 feet from a heat source, open flames or electrical devices, and never to use a candle, match, lighter or other open flame near medical oxygen. Its other rule is shorter: never smoke where medical oxygen is used. Some hospital tip sheets ask for more room: Atrium Health Wake Forest Baptist's home oxygen safety tips say 10 feet from where the oxygen comes out, and add a few worth taping to the fridge:

• Post "no smoking" signs, and warn guests.
• Keep gas stoves, electric razors and hair dryers away from the oxygen, too.
• Don't wear oxygen while cooking, and avoid oil-based lotions, lip balm and aerosol sprays.
• If a fire starts, turn off the oxygen, leave the house and call 911.

If the supplier gives you a distance for your parent's setup, use theirs.

And don't heat the house with the stove. Ready.gov's power outage page warns that a gas stove or oven used for heat raises the risk of carbon monoxide poisoning and fire.

If you use a generator

First ask the device maker or supplier whether the device can run on a generator, as the FDA advises. Then follow the carbon monoxide rules exactly. The Consumer Product Safety Commission's storm safety guidance says:

• Never run a portable generator inside a home, garage, basement, crawlspace or shed. Opening doors and windows won't provide enough ventilation.
• Run it outside, at least 20 feet from the house, with the exhaust pointed away from the home. A porch or carport is too close.
• Install battery-operated carbon monoxide alarms, or alarms with battery backup, on each level and outside sleeping areas, and test them monthly.
• If an alarm sounds, get outside right away, then call 911.

Ready.gov adds: keep it dry, use heavy-duty extension cords, and let it cool before refueling. If nobody at the house can set up and refuel a generator safely, it isn't the backup. Plan around tanks, batteries and a place to go instead.

Wildfire shutoffs: when the outage is on purpose

In wildfire country there's another kind of outage. A Public Safety Power Shutoff is when the utility turns power off on purpose during high winds and dry conditions to prevent a fire. The California Public Utilities Commission explains that the state's investor-owned electric utilities have authority to do this, under rules that include customer notification.

PG&E is plain about it: during a shutoff, all customers on an affected line lose power, Medical Baseline customers included. What enrollment buys is extra advance notice. The CPUC's shutoff guidelines say utilities should, whenever possible, notify affected customers 24 to 48 hours before an anticipated shutoff, and again 1 to 4 hours before if possible. "Whenever possible" matters: the CPUC has cited at least one utility for missing that window. Treat any shutoff warning as the signal to act:

• Call the oxygen supplier for extra tanks.
• Charge every device battery, spare, power chair and phone.
• Check which medicines go in the cooler, and have ice ready.
• Decide whether your parent stays home or goes somewhere with power.

If the utility only has your parent's landline on file, ask whether alerts can also go to your phone.

Insulin and other refrigerated medicines

Ready.gov's general rule: if the power is out for more than a day, throw away medication that should be refrigerated unless the drug's label says otherwise, and call the doctor or pharmacist for a new supply. So ask the pharmacist ahead of time how long each medicine can be stored warmer.

Insulin is the main "label says otherwise" case. The FDA's insulin storage guidance for emergencies says insulin in vials or cartridges supplied by the manufacturers, opened or unopened, may be left unrefrigerated at a temperature between 59°F and 86°F for up to 28 days and continue to work. Insulin that has been diluted or taken out of the original vial should be thrown away within two weeks, insulin in a pump has its own shorter limits, and some newer products differ. If you use ice, avoid freezing the insulin; the FDA says not to use insulin that has been frozen.

Mark every refrigerated medicine on your parent's medication list.

Phones and who gets told

Keep a charged power bank by your parent's chair and a car charger in whichever car would carry them out. If they have a medical alert system with a base unit, ask how long its backup battery lasts; our questions to ask a medical alert company include that one.

The FDA booklet suggests telling the power company, the fire department, family and health care providers when power is lost and again when it's restored. Pick one family member to own those calls, and put the order on your parent's emergency contact list, with the oxygen supplier's after-hours number near the top.

Put a card on every device

A neighbor, a paramedic or the sibling who visits twice a year shouldn't have to guess mid-outage. PG&E recommends labeling equipment with your name, contact information and clear operating instructions, and teaching anyone who might help how to use the equipment and backups.

A laminated index card taped to each device should list:

• Your parent's name and the device type
• Prescribed setting or flow rate, copied from the doctor's order
• Measured battery runtime in hours, and the date you tested it
• How to switch to battery or a tank, in three steps or fewer
• Where spare batteries, the charger, tanks or the manual chair are kept
• Supplier name and 24-hour number
• The electric company's outage number and account number
• Who to call in the family, in order

The card covers the device. The bigger picture (diagnoses, medicines, allergies, code status) goes on a one-page emergency information sheet for paramedics.

When to stay, when to go, and when to call 911

Most outages end in a few hours. Decide what happens when one doesn't before it starts:

• Pick a leave-by point. One sensible rule, worth running past the doctor or supplier: start moving when half the measured battery or tank time is gone and the utility has no restoration estimate. Getting a parent and their equipment into a car takes longer than anyone thinks.
• Know where "somewhere with power" is. A relative's house outside the outage area is best. Ready.gov suggests going to a community location with power if heat or cold is extreme, and checking with local officials about heating and cooling locations. Call ahead to ask whether a site can handle medical equipment.
• Call 911 for an emergency. The FDA says that if you depend on a device to keep you alive, seek emergency services immediately. That includes oxygen running out with no tank left, a ventilator about to lose power, or trouble breathing, chest pain or new confusion.

Don't count on an emergency room as a charging station unless someone confirmed it ahead of time. For longer stays away, our evacuation plan for an elderly parent covers drivers, registries and traveling with oxygen.

After the power comes back

From the FDA's checklist and tips:

1. Check each device's settings. Medical devices often reset to a default mode when power is interrupted.
2. Don't plug in a wet cord or a wet device.
3. Don't use supplies whose packaging is torn, or that are wet, very hot or very cold when they shouldn't be.
4. Recharge every battery and ask the supplier to replace used tanks.

Then note what went wrong. A tank that ran out early or a charger nobody could find is worth more than any checklist.

Frequently asked questions

How long does an oxygen concentrator battery last?

It depends on the model, the flow setting, the battery's age and the temperature. The manual gives a range; the number to trust is the one you measured on your parent's machine at their setting.

What should you do if an oxygen concentrator stops in a power outage?

Switch to a tank at the prescribed flow rate, the way the supplier showed you, and call the supplier's after-hours line about more tanks. If your parent is out of oxygen or having trouble breathing, call 911.

Can you run an oxygen concentrator or CPAP on a generator?

Sometimes. The FDA says to check the user instructions or ask the manufacturer or distributor whether the device can be used with batteries or a generator. If it can, the generator goes outside, at least 20 feet from the house, with working carbon monoxide alarms inside.

Getting it on paper

All of this fits on a page or two: the device list, the measured runtimes, the supplier's numbers, the leave-by rule. You can build it yourself from this guide and a few phone calls. Or Emergency Binder Now can do the organizing from about 25 minutes of guided questions, producing a printable binder with your parent's medicines, doctors and contacts, a one-page sheet for paramedics and the ER, and a list of what's still missing. To see what that looks like, see a sample binder.

This article is general information, not medical advice. Follow the device manufacturer's instructions and your parent's doctor's orders for settings, batteries, oxygen and medicines, and ask the equipment supplier, pharmacist or utility about anything specific to your parent's situation.